Kidney Week

Abstract: SA-PO721

Clinical Outcomes and Effects of Treatment in Older Patients with Idiopathic Membranous Nephropathy

Session Information

• Geriatric Nephrology
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

• 1100 Geriatric Nephrology

Authors

• Kim, Yaeni, Incheon St. Mary's Hosp, Catholic Univ of Korea, Incheon, seoul, Korea (the Republic of)

Yaeni Kim,

• Yoon, Hye Eun, The Catholic University of Korea, Incheon, INCHEON, Korea (the Republic of)

Hye Eun Yoon,

• Hong, Yu Ah, College of Medicine, The Catholic University of Korea , Daejeon, Korea (the Republic of)

Yu Ah Hong,

• Choi, Bumsoon, Division of Nephrology, Department of Internal Medicine, Seoul, Korea (the Republic of)

Bumsoon Choi,

• Park, Cheol Whee, The Catholic University of Korea, Incheon, INCHEON, Korea (the Republic of)

Cheol Whee Park,

• Yang, Chul Woo, Seoul St. Mary's Hospital, Seoul, Korea (the Republic of)

Chul Woo Yang,

• Kim, Yong-Soo, The Catholic University of Korea College of Medicine, Seoul, Korea (the Republic of)

Yong-Soo Kim,

• Hwang, Hyeon Seok, Division of Nephrology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea (the Republic of)

Hyeon Seok Hwang,

Background

Membranous nephropathy (MN) is the most common primary glomerular disease diagnosed in older patients. However, few reports describe the clinical outcomes in older patients with idiopathic MN.

Methods

The outcomes of 135 patients with histologically proven MN were analyzed. ‘Older’ was defined as 60 years of age or older at the time of the renal biopsy. The rates of complete remission (CR), progression to end-stage renal disease (ESRD) and infection were compared between older and younger patients.

Results

The cumulative event rate for achieving CR was inferior (P = 0.012) and that for requiring renal replacement therapy was higher (P = 0.015) in older patients, and they had a greater risk of infection (P = 0.005). Older age was a significant predictor of a lower rate of CR from proteinuria (adjusted odds ratio [OR] = 0.51, 95% confidence interval [CI] 0.26–0.98), and was a robust predictor of infection (adjusted OR = 5.27, 95% CI 1.31–21.20). Conservative treatment was associated with a lower remission rate (P = 0.036) and corticosteroid treatment was less effective in achieving CR (P = 0.014), in preventing progression to ESRD (P = 0.013) and in reducing infection (P = 0.033) in older patients. Cyclosporine treatment had comparable clinical outcomes with regard to CR, ESRD progression, and infection.

Conclusion

Older age was independently associated with inferior rates of CR and greater risk of infection. Treatment modalities affected the outcomes of older patients differently in that cyclosporine treatment is predicted to be more useful than corticosteroids in this population.